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  • Author: Thekla Antoniadou x
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Andreas F. Mavrogenis First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Greece

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Vasilios G. Igoumenou First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Greece

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Thekla Antoniadou First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Greece

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Panayiotis D. Megaloikonomos First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Greece

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George Agrogiannis Second Department of Pathology, National and Kapodistrian University of Athens, School of Medicine, Greece

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Periklis Foukas Second Department of Pathology, National and Kapodistrian University of Athens, School of Medicine, Greece

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Sotirios G. Papageorgiou Second Department of Internal Medicine, Hematology Unit, National and Kapodistrian University of Athens, School of Medicine, Greece

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  • Non-Langerhans cell histiocytosis (N-LCH) summarizes a group of rare diseases with different clinical presentations, pathogenesis and morphology. These include primary cutaneous N-LCH, cutaneous N-LCH with systemic involvement, and primary extracutaneous systemic forms with occasional cutaneous involvement.

  • The juvenile (JXG) and non-juvenile xanthogranuloma (N-JXG) family of histiocytoses are N-LCH: the JXG family consisting of the JXG (cutaneous), xanthoma disseminatum (cutaneous and systemic) and Erdheim-Chester disease (ECD; systemic); and the N-JXG family consisting of the solitary reticulohistiocytoma (cutaneous), multicentric reticulohistiocytosis (cutaneous and systemic) and Rosai-Dorfman disease (RDD; systemic).

  • ECD is a clonal disorder from the JXG family of N-LCH; RDD is a reactive proliferative entity from the non-juvenile xanthogranuloma family of N-LCH.

  • ECD and RDD N-LCH are rare disorders, which are difficult to diagnose, with multi-organ involvement including bone and systemic symptoms, and which respond to therapy in an unpredictable way.

  • The key to successful therapy is accurate identification at tissue level and appropriate staging. Patients should be observed and monitored in a long-term pattern. Prognosis depends on disease extent and the organs involved; it is generally good for RDD disease and variable for ECD.

Cite this article: EFORT Open Rev 2018;3:381-390. DOI: 10.1302/2058-5241.3.170047

Article Type:
Research Article
Category:
General Orthopaedics
DOI:
https://doi.org/10.1302/2058-5241.3.170047
Volume/Issue:
Volume 3: Issue 6
Open access
Andreas F. Mavrogenis First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Panayiotis D. Megaloikonomos First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Thekla Antoniadou First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Vasilios G. Igoumenou First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Georgios N. Panagopoulos First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Leonidas Dimopoulos First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Konstantinos G. Moulakakis Department of Vascular Surgery, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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George S. Sfyroeras Department of Vascular Surgery, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Andreas Lazaris Department of Vascular Surgery, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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  • The lifetime risk for diabetic patients to develop a diabetic foot ulcer (DFU) is 25%. In these patients, the risk of amputation is increased and the outcome deteriorates.

  • More than 50% of non-traumatic lower-extremity amputations are related to DFU infections and 85% of all lower-extremity amputations in patients with diabetes are preceded by an ulcer; up to 70% of diabetic patients with a DFU-related amputation die within five years of their amputation.

  • Optimal management of patients with DFUs must include clinical awareness, adequate blood glucose control, periodic foot inspection, custom therapeutic footwear, off-loading in high-risk patients, local wound care, diagnosis and control of osteomyelitis and ischaemia.

Cite this article: EFORT Open Rev 2018;3:513-525. DOI: 10.1302/2058-5241.3.180010

Article Type:
Research Article
Category:
Foot & Ankle
DOI:
https://doi.org/10.1302/2058-5241.3.180010
Volume/Issue:
Volume 3: Issue 9
Open access